BioMed Research Journal (ISSN:2578-8892)
Abstract
Possibilities of Stereotactic Needle Biopsy (Scnb) for Pathological Nipple Discharge (PND) and Complex Breast Cysts (CBC)
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The main characteristics of CBC and PND are histopathological heterogeneity, high incidence of malignancy, and the need for biopsy. Definitely, the main method of navigation in a guidance biopsy is ultrasound (US), it’s used in 80% of cases, but with CBC, US guidance is limited in cases of atypical echosemiotics, sizes ≥ 2.0 cm, and when visualization of intracystic neoplasia disappears after a fine-needle aspiration. The small size of intraductal neoplasia in patients with PND, US-guided biopsy is possible in a small number (≈20.0%) of cases. The diagnostic and navigation capabilities of pneumocystography (PCG) and ductography (DG) were studied. Oncologically suspicious images on the CBC (internal shadows, thick walls, septations) or on the DG (filling defects, “amputation” lines) were used as targets for navigation through the sCNB. Completed 9 sCNB under PCG and 35 under DG guidance. All intracystic neoplasms were benign, and 3 intraductal carcinomas were identified in the PND. Our first experience suggests, that it is a technically simple procedure that does not require complex equipment and can be performed in an outpatient setting. Having a stable and structured image of intracystic or intraductal neoplasia allows precise stereotactic targeting on the fixed breast. The absence of oncologically suspicious images avoids unnecessary surgery in 73.2% of patients with CBC and in 20.4% with PND. Further experience is needed to establish the effectiveness and practicability of PCG/DG in patients with CBC/PND.
Keywords: Histopathological heterogeneity, Biopsy, Ultrasound (US) guidance, Echosemiotics, Intraductal neoplasia
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